Player Name
First Name
Last Name
Birth Date
*
January
February
March
April
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June
July
August
September
October
November
December
Month
1
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22
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24
25
26
27
28
29
30
31
Day
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
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1978
1977
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1974
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1968
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1956
1955
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1953
1952
1951
1950
1949
1948
1947
1946
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1938
1937
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1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
Year
Player's age
Guardian/Parents name
First Name
Last Name
Home Phone
*
-
Area Code
Phone Number
Cell Phone
-
Area Code
Phone Number
House #/Street Name
*
Town
Postal Code
*
E-mail
*
Shirt Sizes
Youth S
Youth M
Youth L
Adult S
Adult M
Adult L
Adult XL
Adult XXL
Adult XXXL
Baseball Hat Size
Youth
Adult
Time Slot
Interested in Coaching?
*
Yes
No
Assistant Coach
Comments
Player release form
In consideration for the Miracle League of Westchester, Inc. providing the opportunity for this consumer to participate in Miracle League baseball, the undersigned does hereby release and agree to indemnify and hold harmless the Miracle League of Westchester, Inc and its officers and directors from any and all claims for personal injury, death, property damage, or any type of claim or damage (including but not limited to attorney's fees or litigation expenses) resulting from this consumer’s activities in connection with participation in Miracle League baseball or the participation of any family member or guest of the undersigned. We assume all risks and hazards incidental to such participation in Miracle League games and activities and consent for this consumer to receive first-aid and/or emergency care by a qualified Emergency Medical Technician or physician or other person qualified to render medical assistance in the event this consumer suffers an injury during sanctioned games and activities. I agree to provide this consumer’s specific medical information to the Miracle League of Westchester, Inc. so that appropriate precautions and care can be provided to this consumer during sanctioned games and activities. We agree to be present at all games and activities so that we can manage this consumer’s specific needs. We agree to have any and all medication (prescription and nonprescription) for this consumer and shall be solely responsible for dispensing any such medication to this consumer. We understand that there will be media and promotional coverage of Miracle League Games and activities and We give our consent to publish this consumer’s name and picture for such purposes
I have read the player release form
Yes
Digital Signature . I have read and accepted the rules, regulations and player release information provided in this registration
*
First Name
Last Name
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